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>> 8.09.2011

A third of NFL players who rupture their Achilles tendon never play again. The rest are significantly less effectiveness and durable. These are facts, gleaned from an actual medical journal, The Lower Extremity Review:

Of the 31 players who sustained an Achilles tendon rupture, 21 (64%) returned to play in the NFL at an average of 11 months after injury. In the three seasons following their return, those 21 players saw significant decreases in games played and power ratings compared to the three seasons preceding the injury.

This study is being shared far and wide around the Lions-y corners of the Internet, and fans are mutually crying in their coffee this morning knowing that poor Mikel Leshoure’s career is over before it started. “No elite running back has ever returned to top form after this kind of injury,” the pundits are saying, and the fans are hanging their heads and repeating that line to each other.

Days like today are why I started this blog.

A study says that Achilles tears are all but a death sentence for NFL players, eh? Well, let’s have a closer look at that study. In fact, the LER article cites several individual studies, but primarily draws conclusions from one published in 2002:

Parekh et al used a player’s power rating as a measure of functional outcome in the evaluation of “skill players” in the NFL, which included defensive tackles, cornerbacks, linebackers, wide receivers, and running backs.3 The power rating is a measure of a player’s performance using statistics gathered during game play, such as passing and rushing yards for an offensive player and tackles and interceptions for a defensive player. This study showed that 31 acute Achilles tendon ruptures occurred in NFL players between 1997 and 2002. The average age of a player sustaining a rupture was 29, with an average career before injury spanning six years.

Of the 31 players who sustained an Achilles tendon rupture, 21 (64%) returned to play in the NFL at an average of 11 months after injury. In the three seasons following their return, those 21 players saw significant decreases in games played and power ratings compared to the three seasons preceding the injury.

In 1997, there were 30 teams in the NFL. Multiply that by 53, and that’s 1,590 active roster spots. Assume 15% turnover (that’s conservative, 2010’s churn was 20.04%), plus teams 31 and 32 joining the league during the study, and you have roughly 2,800 players in your data set. With just 31 rupturing an Achilles tendon, that’s a very rare injury, affecting only 1.1%.

The average player in this study was 29, and the average career length was six years. Nobody on the Lions exactly matches that. The Lions have two 29-year-olds with seven years of experience: Stephen Peterman and Isaiah Ekejiuba. The 29-year-olds with eight or more years are Nate Burleson, Nathan Vasher, Erik Coleman, and Don Muhlbach. The Lions only had one 28-year-old with six years of experience, Tony Scheffler . . . until they signed Mike Bell and Jerome Harrison to try and replace Leshoure; both of them are 28-year-old six-year veterans.

How many of those guys above could pop an Achilles, take eleven months to rehab, secure a starting spot, and then stay just as productive over the next three years as they were for their first six or seven? None, because the average NFL career only lasts six years—and that’s going by the rosier league estimate. How many studies have we seen proving NFL players—especially tailbacks—hit the wall at 30, injuries or no? All this study has done is point out what we already knew: the shelf life of most NFL players is short, and major injuries are a major obstacle. It has nothing to do with the Achilles tendon.

I don’t have access to injury data, but I’d bet you a dollar that these figures would look exactly the same for ruptured ACLs, fractured patellas, torn biceps, broken femurs, or any other season-ending injury sustained by NFL players. None of this data is specifically relevant to a 21-year-old rookie in the best shape of his life, after a college career where he only carried a full load for one season. No elite running back in recent memory has come back from a ruptured Achilles at full speed, because no elite running back has recently ruptured an Achilles.

The LER article itself repeatedly notes that there’s a huge variety of therapies, rehab schedules, and outcomes, and no set-in-stone way to quickly return to full speed. After sweeping generalizations in the beginning, by the end it all but shrugs its shoulders and goes “Eh, who knows? I guess it depends.” If it depends, then Mikel Leshoure has every possible indicator pointing to success: youth, a light previous workload, no prior Achilles pain, and a long track record of determination to succeed. This is a logical double-edged sword: perhaps Leshoure’s rare combination of size, speed, and agility has already doomed his tendons, just as Aaron Gibson’s shoulder joints could never quite handle the torque their muscles were generating. But right now, the “facts” being used to eulogize Mikel Leshoure’s career simply don’t stand up to examination.

Grieve for the loss of his contributions this season. Grieve for the pain he and his mother must feel as his dream is deferred. But don’t grieve for Mikel Leshoure’s career before it’s begun, and don’t you dare write him off.

31
comments:

Achilles can ruin a career before its started. Health and fitness may be unimportant.

I grew up 3 blocks from a guy (1 yr older) who was drafted by MLB in 3rd round 30 years ago. 93-94 mph, wicked curve and a lefty to boot. Sent straight to AAA out of HS. His pro career lasted 6 weeks. Torn Achilles. Never thru another pitch.

Ty, I wonder what the league average is for "games played and power ratings" simply for all players age 30-33, compared with their numbers when they were age 26-29. Even excluding any injuries at all, I'd expect to see a pretty steep dropoff. As conducted, this study tells you nothing.

We'll never know how good he could have been as a pro without the injury, but Willis McGahee came back from those devastating tears he suffered in the BCS National Championship game.

I also wonder how much of the data is skewed by players who weren't that good to begin with when they were injured and therefore didn't get a full chance to recover. If a big-name player is injured, maybe his team will give him more attention and opportunities to recover than a less-important guy who a team might quickly pressure to prove himself.

Sure, but with modern NFL-caliber therapies of tendons and ligaments, the success rate is so much higher. I had a paragraph in there about Gayle Sayers vs. Jerry Rice (Rice came back from an ACL tear IN THE SAME SEASON as Sayers' career-ending injury), and microfracture surgery going from "dangerous gamble" to Gosder's less-than-a-year turnaround . . . but I thought it distracted from the point of the piece, which is that the study doesn't say what people think it says.

All your points are valid. There are certainly limitations to this study. I'm a little concerned for his future but I am by no means assuming he is done. The problem is your post isn't going to convince anyone who has already made up their mind that leshoure is done. The doom and gloom crowd is out in force today.

"Ty, I wonder what the league average is for "games played and power ratings" simply for all players age 30-33, compared with their numbers when they were age 26-29. Even excluding any injuries at all, I'd expect to see a pretty steep dropoff. As conducted, this study tells you nothing."

Yes, yes, yes, a thousand times yes. A huge part of the observed decline is due to the Achilles typically snapping on older veterans beginning the downside of their careers.

Great points. An older player who loses a year of football no matter the reason is probably only about 70% likely to return. It'd be interesting to see who those 31 players were and look into it on a case-by-case basis

i recently wrote an article for bleacherreport talking about the best and worst pundits (http://bleacherreport.com/articles/798181-ranking-detroits-pundits-the-best-and-worst-sports-writers) and michael sudds, one of our featured columnists, mentioned you and your blog. so my first experience reading you was this gem. well done, and i will certainly keep reading!

Gang,Don't want to be a "downer," but I know first hand about ruptured Achilles tendons. I completely ruptured my left Achilles in late 2009, had surgery, and endured 3 months of physical therapy (three times a week), etc. I'm back to playing basketball in the driveway, shagging fly balls, playing catch, hiking, etc. However, I don't think I will ever be 100% again. The range of motion isn't the same, I have to stretch all the time, and am unable to push off the same as before the injury. Granted, I never went beyond HS athletics, but I can't see anyone being the same after this injury.

Just because nobody has done it doesn't mean it can't be done. As Ty pointed out, nobody born in to a mother in jail has made it to the NFL either. Willpower and determination can rewrite what is possible. Different injury, but many people wrote Cadillac Williams off as being done too. He still has a career and is still lives his dream.

Long time listener, first time caller. Love the blog. You typically make very convincing arguments but I remain skeptical about Leshoure's chances for two reasons:

1. I agree that the study cited isn't terribly relevant. The problem is the lack of evidence to show that recovering from this injury is likely, regardless of age. We simply haven't seen many players make a complete recovery from a ruptured Achilles. I'm sure it is at least *possible* but certainly not commonplace. And while I don't have relevant statistics in front of me, an overall 67% comeback rate doesn't sound very good to me. These days, an ACL is no big deal in the long term--if a player tears an ACL, it seems a foregone conclusion that they'll recover. We haven't seen much of that kind of success with Achilles injuries.

2. I'm a Lions fan and have been classically conditioned to expect disaster.

I expect the latter has more to do with my pessimism.

Regardless, I wish Leshoure a speedy recovery and truly hope he can prove us skeptics wrong. Hell, if he plays 16 games in 2012, I'll buy his jersey.

Sorry Ty, he's done in the NFL. If he ever racks up more then 500 yards (career) in the NFL I'll be totally astounded. Going to have to take your dollar bet. Hope someday I pay you, but I think I'm safe. Sucks, but it is what it is.

I think the reason that sports fans are desensitized to ACLs and rotator cuffs and stuff is that it's so common. From ty's stats, you can see that ruptured achilles is pretty rare, especially is the younger, higher profile players. We haven't seen any success stories because we haven't seen any coverage of the injury really.

As tainted as that study may be, Mikel is done. I'm sure he'll come back, probably bounce around the league a bit, but never make an impact. I feel bad for the kid, but it is what it is. I hope he saved that signing bonus and goes back for that degree.

I was reading that supposedly one of the most common causes of an achilles tear in younger athletes is a result of steroid use. Not saying Mikel falls into that but I'm surprised it hasn't been brought up.

Telemakhos is right that knowing who these 31 players were would be helpful. As someone who has studied how to conduct studies, and based only on the information Ty provided, it sounds like this study has several confounds (problems) that make it difficult to generalize the results.

The fact that the average player in the study was 29 years old at the time of injury points to an age bias in sampling. It seems like, generally speaking, Achilles ruptures happen after guys have accumulated several years of NFL wear-and-tear on their bodies. From the study:

"Parekh et al also reported a decline in power ratings for certain skill players, specifically running backs and receivers, in the three seasons prior to their acute Achilles tendon rupture. It is possible that this observation suggests the presence of a prodromal period of Achilles tendinosis."

All this inherently means that, if you set out to study Achilles ruptures in NFL players, your sample is not going to be representative of NFL players in general. Instead, it's going to include more than a fair share of older guys who were talented/healthy enough to stick around the NFL awhile and build up that wear-and-tear. These guys are, by definition, better than average. Maybe JaMarcus Russell would have ruptured his Achilles at 29, but we'll never know 'cause he's not in the league anymore. And of course the "average" player in this study who did manage to come back had a decline in production! He got hurt at the end of his prime years, which must have been better than average or else he wouldn't have lasted so long. Sustaining that production beyond age 30 would be tough WITHOUT an injury. In fact, the WRs & RBs in the study were already declining BEFORE the injury!

This natural age bias in sampling would also lead to a position bias. Is it easier to last in the NFL until age 29 as a wide receiver or running back? It's much more likely that a WR will suffer an Achilles rupture at some point during his 5-10 year career than a running back will during his 3-6 year career. Therefore, there are probably going to be a disproportionate ratio of WRs-to-RBs in this study compared to the actual ratio of WRs-to-RBs in the NFL. Also, this study only looked at "skill players" (DTs, CBs, LBs, WRs, and RBs) which further reduces the generalizability of the results.

Another confound can be found in those 10 players who didn't make it back. We have no idea why. Could they just not get over the injury? Did they decide "I'm about 30 and I've got 6 years of NFL paychecks in the bank - I can call it quits now, rehab this thing on my own schedule, and get on with my post-NFL life."? Did they rehab successfully and still desire to play, only to find that no team wanted to sign a 30 year-old coming off an Achilles rupture? Just because a guy DIDN'T come back doesn't mean he COULDN'T come back.

Ty's overall point was that this particular, frequently-cited study isn't really that relevant when talking about LeShoure specifically. I think the problems with this study show that point to be valid. He's not saying this injury isn't serious, just that it doesn't spell absolute doom for LeShoure as some folks have used this study to suggest. The study is a vague look at Achilles injuries to NFL players. It suggests very little about Achilles injuries to 21-year-old rookie running backs other than "Well, they're definitely not a GOOD thing."

I think the reason that sports fans are desensitized to ACLs and rotator cuffs and stuff is that it's so common. From ty's stats, you can see that ruptured achilles is pretty rare, especially is the younger, higher profile players. We haven't seen any success stories because we haven't seen any coverage of the injury really.-------------------------telemakhos-That's my point, exactly. There isn't enough evidence to demonstrate that someone is "likely" to come back fully healthy from a ruptured Achilles. I appreciate Ty's dismantling of the pessimistic view but the case for optimism isn't really well-supported either.

The average NFL career of a runningback is 3 years, but the point is it's career-ending for a RB. Kevin Smith will be doing better than LeShoure after this injury. Look at Andre Brown and Lendale White. We were right to cry in our coffee and get it out of our system because with a guy LeShoure's size and whose college career relied on his explosiveness and lateral speed there's no way he's going to return the same. Maybe a tailback but for a fullback that runs like a tail his return to glory isn't going to happen.

It's the saddest thing I've seen for the Lions in a long time but it's better to accept it now than gametime.

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